Indicator Based Assessment of Medicines Procurement Practices in Various Public Sector Hospitals of District Srinagar
Introduction: An organized and systematic drug procurement process based on well-established scientific principles effectively ensures the availability of right medicines in the right quantities, at reasonable prices, and at recognized standards of quality. It ensures ‘value for money’ and ‘economies of scale’ to the best possible extent.
Methods: This study was carried out to evaluate various drug procurement and tendering practices prevalent at three tertiary care public health facilities of District Srinagar, the summer capital of J&K state. One children’s tertiary care hospital (CH), one Govt. Medical College Hospital (MCH), one district hospital (DH) was selected for the study. Two different pharmaceutical supply chains were involved in procurement of medicines for the study hospitals. A set of 149 qualitative and 15 quantitative indicators were developed to evaluate drug procurement practices in these healthcare settings.
Results: Qualitative indicator based assessment revealed that a centralised procurement and decentralised distribution practice was being followed by both the supply chains studied. Procurement funds were found to be grossly inadequate whereas pre-qualification of suppliers was undertaken. Competitive e-tendering method was followed using double envelope system. However, rate contracts were not regularly updated and there were no means available to check and determine the quality of drugs effectively. Available pool of human resource was found to be inadequate and there were no standard procedures in place to monitor the performance of procurement and supply system on regular basis.
Conclusion: Appropriate measures need to be taken for proper selection, quantification, forecasting and procurement of medicines in accordance with well established guidelines to make the supply chain more efficient. Allocation and disbursement of funds for procurement should also be sufficient and timely to cater to the needs of individual hospitals across all levels of care.
2. Gilson AM, Maurer MA, Ryan KM, Skemp-Brown M, Husain A, Cleary JF. Ensuring patient access to essential medicines while minimizing harmful use: a revised World Health Organization tool to improve national drug control policy. Jour of Pain and Pallit Care Pharmacoth 2011; 25(3):246-51.
3. Cameron A, Ewen M, Ross-Degnan D, Ball D, Laing R. Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis. Lancet 2009; 373(9659):240-49.
4. Deroeck D, Bawazir SA, Carrasco P, Kaddar M, Brooks A, Fitzsimmons J, Andrus J. Regional group purchasing of vaccines: Review of the Pan American Health Organization EPI revolving fund and the Gulf Cooperation Council group-purchasing program. Int J Health Plan and Management 2006; 21(1):23-43.
5. WHO. World Health Organization. Procurement of vaccines for public-sector programmes: a reference manual. Geneva: WHO; 1999. WHO/V&B/99.12. Available at pdf.usaid.gov/pdfdocs/Pnacn114.pdf (Accessed on December 10th, 2015).
6. Van Weele AJ. Purchasing and supply chain management: Analysis, strategy, planning and practice. Learning EMEA; 2009.
7. WHO. How to investigate drug use in health facilities (Selected drug use indicators). Geneva: World Health Organization, WHO/DAP/93.1. Available at apps.who.int/medicinedocs/en/d/Js2289e/ (Accessed on December 10th, 2015).
8. Diack A, Seiter A, Hawkins L, Dweik IS. 2010. Assessment of governance and corruption in the pharmaceutical sector: Lessons learned from low and middle income countries. Available at apps.who.int/medicinedocs/documents/s17507en/s17507en.pdf(Accessed on November 20th 2015).
9. Cohen JC, Mrazek M, Hawkins L. Tackling corruption in the pharmaceutical systems worldwide with courage and conviction. ClinPharmacolTher 2007; 81(3):445-49.
10. WHO. World Health Organization. Report of a WHO meeting on drug policies and management: procurement and financing of essential drugs. Geneva: World Health Organization; 1984. WHO/DAP/84.5. Available at apps.who.int/medicinedocs/documents/s16768e/s16768e.pdf. (Accessed on December 10th, 2015).
11. Selvaraj S, Karan AK. Deepening health insecurity in India: evidence from national sample surveys since 1980s. Econ and Pol Weekly 2009; 3:55-60.
12. Pratyush S. Enhancing value in public procurement. Special addresses at Conference on Competition, Public Policy and Common men.’ Available at:www.cci.gov.in(Accessed on December 30th 2015).
13. Chokshi M., Mongia R and Wattal V. 2015. Drug quality and safety issues in India. Available at http://icrier.org/pdf/Working_Paper_310.pdf. (Accessed on December 14th, 2015).
14. World Bank. Procurement of pharmaceuticals and vaccines. Washington, DC: World Bank; 2001. Procurement technical note no. 4.3.2. Available https://openknowledge.worldbank.org/bitstream/handle/multi0page.pdf(Accessed on December 26th 2015)
15. Chaudhury RR, Parameswar R, Gupta U, Sharma S, Tekur U, Bapna JS. Quality medicines for the poor: experience of the Delhi programme on rational use of drugs. Health Pol and Plann 2005; 20(2):124-36.
16. Garuba HA, Kohler JC, Huisman AM. Transparency in Nigeria's public pharmaceutical sector: perceptions from policy makers. Global Health 2009; 29(10):5-14.
17.OECD. Organisation for economic co-operation and development, 2014. Pharmaceutical pricing policies in a global market. OECD health policy studies. Paris, France.Available at http://www.oecd.org/els/health-systems/health-data.htm (Accessed on December 30th 2
Copyright (c) 2016 International Archives of BioMedical and Clinical Research
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.